放射治疗诱发恶性肿瘤10例临床分析

目的：探讨放射线诱发恶性肿瘤的有关因素。方法：回顾性分析10例放射线治疗后诱发的恶性肿瘤。原发肿瘤为鼻咽癌5例，扁桃体癌、扁桃体恶性淋巴瘤、鼻腔内翻乳头状瘤恶变、左眼眶下血管外皮瘤及垂体腺瘤各1例。放射原为6MVX线或^60Co γ线，放射剂量30－77Gy，常规分割。结果：放射治疗后2－26年，在照射野内或射野边缘诱发恶性肿瘤。结论：放射线可诱发恶性肿瘤，与照射部位、射线剂量、年龄等因素有关。

Radiation Induced Malignant Tumors (A Report of 10 cases)

Objective: It attempted to analyze possible etiologic factors of radiation induced malignant tumors. Methods: 10 cases of radiation induced malignant tumors were reported. Their primary tumors were nasopharyngeal carcinoma 5, tonsillar malignant lymphoma 1, tonsillar carcinoma 1, malignant change of the inverted papilloma 1, pituitary adenoma 1, suborbital hemoagiopericgtoma 1. The initial radiotherapy was 60 Co or 6 MV X ray, conventionally fractionated at dose of 30~75 Gy. Results: After 2~26 years of the initial radiotherapy 10 patients developed tumors within the original radiation fields. The tumors were malignant peripheral nerve sheath tumors, parotid carcinoma, well differentiated squamous carcinoma of gingival, squamous carcinoma of external ear. Squamous carcinoma of the root of the tongue. 3 cases poorly differentiated squamous carcinoma of naopharyneal, maxillary sinus cancer and fibrosarcoma of the nasal cavity respectively. Conclusion: The etiologic factors of radiation induced cancer are related to total dose, age and the site of radiotherapy.